Medical tubing and catheter control

ABSTRACT

One embodiment is an improved method for providing a tube for attachment to a medical device such as a catheter that provides for intermittent changes in tube path length as a result of body movement thereby reducing the stress and pain caused by pulling on the device, as well as the optional provision to provide a very low, controlled tension that provides improved stability of the medical device without damage to the surrounding body tissues. This controlled tension can be applied or removed intermittently by a medical practitioner or the patient. The tubal devices shown in Fig and Fig both provide for extension in tubal path length while simultaneously providing for intermittent or continuous low tension pull on the catheter. Provision is also made for a continuous smooth fluid path with no moving internal parts.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of PPA 61/359,912 filed Jun. 30, 2010 and PPA 61/478,566 filed Apr. 25, 2011

FEDERALLY SPONSORED RESEARCH

NONE

SEQUENCE LISTING

Not Applicable

BACKGROUND

1. Field of Invention

This invention relates to fluid handling lines and their attachment to catheters or other medical devices, more specifically to tube length compensation features that help to stabilize and isolate the catheter or other medical devices.

2. Prior Art

There are many areas in the medical field where a fluid handling tube is attached to a device fastened onto or into the body. Problems arise that are the result of body movements that alter the length of the tubal path, instances where the tube is subjected to sudden hard tugs, and movement of the device itself as a result of skin movement even when fastened down with adhesive tape. In cases where the device is a catheter, whether urinary, IV, or other, the movement caused and the forces exerted may cause damage to the organ or vein as well as actual dislodgement of the catheter

In the case of urinary catheters, which are flexible tubes, usually made of Latex or a Latex blend, that are passed through the urethra and into the bladder. The catheter is retained inside the bladder by means of a balloon, located at the inserted end, which is inflated with sterile water. The diameter of the inflated balloon is greater than the internal diameter of the urethra. The external end of the catheter is attached to a drainage tube which leads to a drainage bag. The drainage tube is usually secured to the leg of the patient in order to help control wild swings in the tubing and the resultant effects on the catheter. Care must be taken, when securing the drainage tube to the leg, to ensure a sufficient length of tubing is given to form a loop. If not enough slack tubing is given, the patient risks damaging their bladder if they stretch their leg too far. This configuration, however, creates another problem. The inflated balloon prevents the catheter from accidentally being pulled out of the bladder, but there is nothing restricting the catheter from moving further into the bladder. Because of the extra length of tubing loop between the connection point on the leg and the catheter, the catheter is free to move within the bladder, and will move every time the patient's leg moves. This movement causes both discomfort and irritation and, as a result, an increased risk of infection. When the catheter moves in far enough, the top of the catheter will bump against the bladder top. This is thought by many to be a cause for bladder spasms, a very painful condition. As the catheter moves back down, such as when the leg is stretched sideways, the tubing will pull out the catheter until the balloon rests on the bottom of the bladder. The pulling in and pushing out, or pistoning, of the catheter, causes irritation of the urethra, but more significantly, increases the risk of catheter associated urinary tract infections.

Current state of the art for urinary catheter securement is a “STATLOCK” device which can be shown to be self defeating. In this case, the catheter itself is fastened to the thigh thus guaranteeing that the catheter will piston in and out with every leg movement. If placed improperly, severe bladder damage may result.

According to the Centers for Disease Control and Prevention (CDC) website, (http://www.cdc.gov/ncidod/eid/vol7no2/maki.htm), each year, 30,000,000 urinary catheters are inserted into over 5 million patients in acute care hospitals and extended care facilities in the U.S. alone. Up to 25% of these patients, over one million per year, develop catheter associated urinary tract infection (CAUTI), when requiring catheterization for ≧7 days; the daily risk is 5%. CAUTI is the most common nosocomial infection, and the second most common cause of nosocomial blood stream infection. Studies suggest that patients who have developed CAUTI have an increased institutional death rate, unrelated to the development of urosepsis. As the population grows in size and in age, and the average life expectancy rate increases, each year more and more people will require catheterization. This along with the unwillingness, of a growing number of health insurance companies, to pay hospitals for nosocomial infection treatment, creates an urgent need for a solution.

SUMMARY

To effectively reduce the discomfort and risk of infection caused by the use of a Foley Catheter, a controlling device is needed to compensate for the changes in the length of the drainage tube path, as the distance from the catheter to the attachment point changes. In this way, there is no need for a free loop of slack drainage tubing. The free loop causes an increase in pistoning, as the loop swings and changes size with the patient's movement. The free loop can also get caught on clothing resulting in a substantial pull on the catheter, which can damage the catheter as well as the patient's bladder and/or urethra. All of these movements further increase the irritation on the penis tip.

To further reduce pistoning, the controlling device described herein could provide a continuous, but minimal pull (Minimal pull is that force great enough to hold the catheter balloon at the bottom of the bladder, but not great enough to cause damage to the blood vessels and tissue on the bladder bottom if applied continuously, present approximation, subject to actual testing, is less than 3 Oz*.) on an engaged Foley catheter such that the balloon of the catheter will always be resting on the bottom of the bladder. This action, in conjunction with the means of compensating for the changes in the length of the drain tube path from the catheter to the attachment point on the thigh, will protect the bladder and the urethra from damage caused by a very strong pull on the catheter, such as occurs when the tubing catches on something or the leg movement causes an excessive pull as well as reducing the pistoning action of the urethra. The urethra is further protected by reducing the pistoning of the catheter and the associated introduction of foreign matter that adheres to the moist catheter when it exits the urethra, and is re-introduced into the urethra when it re-enters with the accumulated debris, lint and fecal matter that has adhered to the moist catheter.

Furthermore, the said method is non-invasive and low cost. It could potentially save hospitals millions of dollars each year by reducing time and medication costs associated with the treatment of CAUTI, not to mention the savings of those lives that are already in a weakened state and could not withstand yet another infection.

DRAWINGS—FIGS. 1 to 15B

FIG. 1 shows a typical male Foley urinary catheter, inside the bladder, attached to the compensating device with a connector. The device attached with adhesive tape to the thigh, and the outgoing line leading to a Collection bag.

FIG. 2 a shows a front view of the tubing and catheter controller in accordance with one embodiment.

FIG. 2 b shows an exploded view the tubing and catheter controller in accordance with one embodiment.

FIG. 3 a shows the tubing and catheter controller with the calibrated force acting on the tension spring in accordance with one embodiment.

FIG. 3 b shows the tubing and catheter controller with a force greater than the calibrated force, causing the tension spring to lengthen and allowing a greater length of drainage tube

FIGS. 4 a and 4 b show an alternate embodiment of the controller

FIG. 5 shows an alternate embodiment of the controller

FIG. 6 shows a top and bottom view of an adjustment dial in accordance with one embodiment

FIG. 7 shows a spring loaded slide with the spring un-compressed and with the spring compressed in accordance with one embodiment

FIG. 8 shows a base with a Dial mounting post and recesses for the dial and slide in accordance with one embodiment

FIG. 9 a shows a front view of an alternate embodiment with a means for adjusting the tension of the tension spring in the un-tensioned position

FIG. 9 b shows a cross section view of one embodiment with a means for adjusting the tension of the tension spring in the minimum-tensioned position.

FIG. 10 a shows a front view of an alternate embodiment with a means for adjusting the tension of the tension spring in the tensioned position

FIG. 10 b shows a cross section view of one embodiment with a means for adjusting the tension of the tension spring in the tensioned position

FIG. 11 a shows a cross section view of one embodiment with a means for adjusting the tension of the tension spring and with a cover plate

FIG. 11B shows a cross section view of one embodiment with a means for adjusting the tension of the tension spring in the tensioned position and with a cover plate

FIG. 12 shows another embodiment that would allow for compensating tube path length changes, while also providing a means to keep a low adjustable tension on the catheter.

FIG. 13 shows another embodiment that utilizes a controlled thin wall elastomer type of tube in a protective shell that provides a smooth continuous path for the fluid while allowing for tube length compensation as well as a continuous low tension pull on the catheter.

FIGS. 14A, 14B, and 14C shows a device similar to FIG. 13, but with the added feature of an enclosed telescoping inner shell. This arrangement allows for greater tube length compensation for the same size device as well as a means to easily remove the constant tension feature without professional help.

FIGS. 15A and 15B shows an embodiment of the same concept as applied to an IV Catheter.

DRAWINGS—REFERENCE NUMERALS

-   100—Foley Catheter -   102—Attachment Tape -   104—Compensating Device -   106—Incoming Tube -   108—Outgoing tube -   Tube Connectors -   200—First Embodiment -   202—Catheter Tensioner base -   204—Drainage Tube -   206—Connection to External End of Catheter -   208—Connection to Collection Bag -   210—Tension Spring -   212—Cover plate -   214—Attachment of tube to base -   215—Bottom edge of base -   216—Underside surface of base -   218—Tube compartment -   220—Bottom section of Base -   302—Calibration Markings -   304—Direction of force by Tension Spring -   306—Direction of Tension on Foley Catheter -   400—Second Embodiment -   402—Cover strap -   404—Adhesive section on cover strap -   500—Third Embodiment -   502—Injection Molded Base -   504—Cover plate -   506—Living Hinge -   508—Tube compartment walls -   510A—Snap fitting (male end) -   510B—Snap fitting (female end) -   512—Adhesive release holes/Breathability holes -   600—Tension Adjustment Cam -   602—Recess for mounting post -   604—Attachment point of tension spring -   606—Recess for slide in Un-tensioned position -   608—Recess for slide in Tensioned position -   610—Dial handle -   700—Slide -   702—Compression Spring (non-compressed) -   702A—Compression Spring (compressed) -   704—Front of slide -   706—Slide Handle -   800—Base for Adjustable Embodiment -   802—Post for mounting Cam -   804—Dial compartment -   806—Slide compartment -   808—Rib for preventing Drainage Tube/Tension Spring Contact. -   900—Adjustable Embodiment -   902—Cover for Adjustable Embodiment -   904—Cutout for Dial Handle -   906—Cutout for Slide Handle -   1210—Container -   1212—Tube Bottom -   1214—Hole -   1220—Expansion Unit -   1222—Bottom Tube -   1226—Upper Tube -   1228—Bellows Type Section -   1229—Projection on expansion unit -   1230—Cap -   1232—Finishing Coil -   1240—Spring -   1242—Threaded Section -   1244—Cap unit Projection -   1310—Outer Shell Cover -   1311—Outer Shell Exiting Cover End -   1312—Incoming Tube -   1313—Left/Exiting Tube -   1314—Elastomer Tube -   1316—D Shaped Slider -   1317—Outer Shell Exiting End Hole -   1319—Outershell Incoming Cover End -   1322—Stop Projection -   1324—Outer Shell Cover End -   1410—OUTER SHELL -   1411—OUTER SHELL EXIT END -   1412—IN COMING TUBE -   1413—EXITING TUBE -   1414—ELASTIC TUBE -   1415—SECONDARY SLIDER POSITION -   1416—SLIDER -   1417—SLIDER HOLE -   1418—SAFETY PIN ENTRY HOLE 1418 -   1419—OUTERSHELL INCOMING END -   1420—GLUED JOINT -   1422—MAXIMUM SIZE STOP -   1424—EXITING HOLE -   1430—OUTER SHELL BOTTOM PLATE -   1432—SLIDER STOP -   1434—INNER SHELL STOP -   1440—INNER SHELL -   1442—INNER SHELL BACK PLATE -   1444—INNER SHELL INCOMING HOLE -   1446—INNER SHELL MAX MOV STOP -   1448—INNER SHELL LEADING EDGE -   1450—SAFETY PIN -   1512—MEDICAL TUBING -   1514—ELASTIC TUBE -   1552—IV OUTER SHELL -   1554—IV INNER SHELL -   1556—IV NEEDLE/CATHETER -   1558—INNER SHELL FLAIR -   1560—INNER SHELL STOP

DETAILED DESCRIPTION First Embodiment

FIG. 1 shows a typical male Foley urinary catheter 100, inside the bladder with the incoming tube 106 leading to the compensating device 104, thru connector 110. The device 104 is attached to the thigh with adhesive tape 102. The outgoing line 108 leads to the Collection bag 112.

One embodiment of the controller, herein called the First Embodiment 200, is shown in FIGS. 2A through 3B. FIG. 2A shows a front view of the First Embodiment 200. FIG. 2B shows an exploded view of the First embodiment 200. A base 202, designed to house a flexible drainage tube 204 and a tension spring 210, is molded out of a soft foam rubber or plastic and has an adhesive back surface 216 (FIG. 2B). The drainage tube 204 sits in the drainage tube compartment 218. One end 206 of the drainage tube 204 is connected to the external end of the Foley Catheter 100. The other end 208 of the drainage tube 204 is connected to a drainage collection bag. A tension spring 210 bends and holds the drainage tube 204 as seen in FIG. 2A. The Tension spring 210 and the side of the drainage tube 208, are attached to the base 202 in section 214. The geometry of section 214, positions the drainage tube 204 at an angle relative to the bottom edge 215 of the base 202 that is appropriate whether the leg is straight of bent. Shown in FIG. 2B, this embodiment uses a base 202 that is molded with a curve to fit the contour of the leg, other embodiments might be flexible and would not need to be molded with a curve. A cover plate 212 is attached to the base 202 (FIG. 2B) creating a housing for the drainage tube 204 which allows for the changing of length, while keeping the drainage tube 204 parallel to the body. FIG. 3 a shows the First Embodiment 200 with a safe predetermined force of 3 Oz acting on the tension spring 210. The resulting position of the drainage tube 204 is in line with pre-marked calibration markings 302. The line of force 304 caused by the tension spring 210, is in line with the direction 306 of the Foley catheter tubing. FIG. 3 b shows the First Embodiment 200 with a force greater than 3 Oz acting on the tension spring 210, causing the tension spring 210 to lengthen and allowing a greater length of drainage tube 204 to be delivered.

OPERATION First Embodiment

The Catheter Controller 200, is attached to the patients leg by means of an adhesive surface 216 on the backside of the base 202 (FIG. 2 b). It is orientated such that the end of the drainage tube 208 points in the general direction of the drainage bag, where it will then be connected. As can be seen by FIG. 2 a, the end 208 is attached to the base 202 and positioned approximately 45° relative to the bottom edge 215 of the base 202. The 45° angle of the drainage tube 204 optimally places the end 208 such that the maximum amount of bend the drainage tube 204 will have to undergo, is about 45° regardless of the patient's leg position. The other end 206, is connected to the external end of the Foley Catheter 100 and is held in constant tension by the tension spring 210, when placed in between the calibration markings 302 shown in FIG. 3 a. (see method of operation for securing controller below) Shown in FIGS. 3 a and 3 b, the line of tension 304 of the tension spring 210, is always parallel with the path 306 of the drainage tube end 206 and therefore the Foley catheter 100 itself. The tension spring 210 effectively pulls on the Catheter 100, with a safe, predetermined force of less than 3 Oz (this force has been calculated to be safe, but is subject to change upon further testing). This calculated force, is distributed over the contact surface between the balloon and the bottom of the bladder, resulting in a surface pressure that will be less than the blood pressure in the blood vessels around the base of the bladder. This predetermined force is strong enough to keep the Foley catheter 100 secure, but not large enough to damage the blood vessels on the bottom of the bladder 104. By preventing the Foley Catheter 100 from moving within the bladder 104, catheter pistoning is greatly reduced leading to a reduction in patient discomfort as well as lowering the risk of infection. A set of marked calibration lines 302 is provided such that the tube can be moved within these lines and the correct amount of tension will be set. This point is where the tension is at its minimum and the distance from the leg attachment point to the catheter is at its minimum. When a force greater than said safe, predetermined force of the tension spring 210, is experienced, such as when the patient's leg is stretched, the tension spring 210 lets out and more drainage tube length is allotted (shown in FIG. 3 b). This prevents any force greater than the safe predetermined maximum force, from pulling on the Foley Catheter 100 and potentially causing damage to the bladder 104. This configuration constantly keeps a safe tension on the Foley Catheter 100 while giving or taking excess lengths of drainage tubing 204 to account for different leg and body movement. The cover 212 creates an enclosed housing for the drainage tube 204 which allows for the changing of length, while keeping the drainage tube 204 parallel to the body. The cover 212 prevents the drainage tube 204 from getting caught on anything, and also creates a desirable low profile for the user, especially when worn under clothing.

The method of operation for securing the controller, when the controller is used for catheter tension control, is as follows:

1. Pull lightly on the catheter till balloon is resting on bladder bottom. 2. Cut tubing end 206 so that when the catheter connector (not shown), is actually attached to the tube, and when the connector is then connected to the catheter, which is now in its most downward position with the balloon resting on the bladder bottom, the controller will be in a position about ½ to 1 Inch short of the final desired position on the thigh. 3. Slide controller along the thigh until the tubing 206 or tension spring 210 is at the calibration lines 302 and the controller is positioned so that the elastic spring, the tubing side 206 and the catheter are all in a straight line. 4. Remove backing paper and adhere controller to the thigh

DETAILED DESCRIPTION Other Embodiments

FIGS. 4A and 48 show another embodiment herein called the Second Embodiment 400. Instead of a cover plate 212, a strap 402 is attached to the base 202 and folds over the drainage tube 204, and attaches to the patient's leg, or alternatively, to the bottom section of the base 220, using an adhesive placed on one end 404. FIG. 4A shows the Second Embodiment 400 in the open position and FIG. 4B shows the Second embodiment 400 in the closed position. FIG. 5 shows another embodiment herein called the Third Embodiment 500. In this Embodiment 500, the base 502 and cover 504 are molded as one piece, joined by a living hinge section 506. The living hinge 506 allows for the cover 504 to fold over and connect to the base 502 through a snap fitting 510A (male) and 510B (female). The drainage tube compartment 218 shown in FIG. 2 b is replicated in this embodiment 500 by molded walls 508. A predetermined hole pattern 512 is molded into the bottom surface of the base 502. This hole pattern 512 allows the skin to breath while the controller is attached, and serves as an adhesive release aid as adhesive solvent can be applied through the holes 512 and onto the skin. Another embodiment may include a means for adjusting the tension of the tension spring 210. This can be accomplished by a number of methods. One such method uses a rotatable dial 600 shown in FIG. 6, a spring loaded slide 700 shown in FIG. 7, and a modified base 800 shown in FIG. 8. As shown in FIG. 6, the dial 600, has a recess for a mounting post 602, an attachment point 604 for the tension spring 210, a recess 606 for the slide 700, when the tension spring 210 is at the lower tension setting, and a recess 608 for the slide 700, when the tension spring 210 is at the higher tension setting. Ideally, the lower tension setting provides just enough tension to keep the tube loop within the device.

The higher tension setting is used when the device is employed to maintain a constant minimum tension on the catheter. In the latter case, there is the possibility for the doctor or the patient to remove the constant tension on the catheter if the constant tension creates a problem. A dial handle 610 is also provided to aid in the rotation of the dial 600. Shown in FIG. 7, the slide contains a molded compression spring section 702, (shown compressed as 702A), a front section 704 which fits into the recesses 606, and 608, of the dial 600, and a slide handle 706 to aid in the movement of the slide 700. Shown in FIG. 8, the base 800, contains a mounting post 802 for the dial 600, a dial compartment 804, a slide compartment 806, and a rib 808 for preventing the drainage tube 204 from contacting the tension spring 210, and as an aid in reducing any possibility of kinking. FIGS. 9 a, 9 b, 10 a, 10 b and 11 a and 11 b, show the completed assembly of the adjustable embodiment 900. FIG. 9 a shows this embodiment 900 in the low tension position. The tension spring 210, attaches to the surface 604 of the dial 600. The dial 600 is placed in the dial recess 804 of the base 800 such that the mounting post 802 fits into the mounting post recess 602. The slide 700, sits in the slide compartment 806, of the base 800. In the lower tensioned position, the front section 704 of the slide 700 rests against recess 606 of the dial 600 and prevents any clockwise rotation of the dial 600. In this position (FIG. 9 a), the compression spring 702A of the slide 700, is compressed. The attachment point 604 of the tension spring 210 to the dial 600 is in the vertical position, meaning no tension is being applied. FIG. 9 b shows a cross section view of the adjustable embodiment 900 in the un-tensioned position. FIG. 10 a shows the adjustable embodiment 900 in the tensioned position. The dial 600 has been rotated 90° counter clockwise, causing the tension spring 210 to elongate and thus be in the higher tension mode. With the dial 600, rotated into this position, the slide 700 is pushed forward by the slide's compression spring 702, and rests in the tensioned recess 608 of the dial 600. The front section 704 of the slide 700 prevents any further rotation of the dial 600. FIG. 10 b shows a cross section view of the adjustable embodiment 900 in the tensioned position. FIGS. 11 a and 11 b show cross sections of the adjustable embodiment 900 with a cover 902 in the closed position. FIG. 11 a shows the embodiment 900 in the lower tensioned position, while FIG. 11 b shows the embodiment 900 in the higher tensioned position. A recess 904 in the cover 902 allows for the dial handle 610 to protrude through when the cover 902 is closed. A similar recess 906 is provided for the slide handle 706. This configuration, allows the user to adjust the tension of the tension spring 210 without having to open the cover. By pushing the slide 700 to the right using the slide handle 706, the dial 600 is now able to be rotated using the dial handle 610 and tension can either be applied or alleviated.

An example of yet another embodiment is shown in FIG. 12. This device provides a means of adjustment to finely control the degree of force produced by the tubing before the tube lengthens or contracts as a result of leg movements. Container 1210 provides protection for the expandable tubing 1228 and provides a place of attachment to the thigh. The attachment may be direct by means of an adhesive. The container would also prevent the flexible area from bending and collapsing on itself thereby restricting flow to the collection bag.

Providing a pivoting means for the container, preferably lockable, that allows the container to pivot in order to reduce the binding friction on the tubing when the pull is other than in a straight up or down direction. The pivot may be ball shaped to give a degree of movement in all directions. This type of lockable pivot is commercially available.

Container 1210 is a hollow tube, with a tube bottom 1212, that has a hole 1214 thru which bottom tube 1222, located at the lower end of compensating expansion unit 1228 passes through, and is attached to container 1210 at the hole 1214.

Compensating expansion unit 1228 is shown with a bellows type section 1228 that provides the expansion in this case. The upper tube 1226 passes freely thru a hole in cap 1230. Cap 1230 has a threaded section 1242 running down most of its interior length that engages with the threaded section at the top of container 1210.

Spring 1240, which has a smooth finishing coil 1232 at both ends that catch under projections 1229 on the expansion unit and projection 1244 on the cap unit.

Other embodiments may be used as a method for controlling any other tubing system where expansion and contraction are of concern. By forming a loop, attaching an elastic means across the base of the loop, attaching one end of the elastic loop with the tube attached to the securement point desired, and covering the loop with a sheet of material, the tubing system is constantly in tension, and is kept parallel to the body part, but not close enough to inhibit movement of the tube as the loop expands and contracts. This covering can be anything from a fabric loosely spread over the loop and taped to the body to a sheet of material mounted in such a way as to be parallel to the body but spaced a distance away that does not inhibit the tubing movement as it expands and contracts.

It should be noted, that the bellows section of the expansion unit could be replaced with a section of coiled tubing instead. In this case provision would be made for a projection at a point onto just above the coiled section on the upper tube onto which the spring could grasp.

The ideal arrangement would have the outer tube adjusted to a height that provides enough springiness to just support the tubing above or around it so that any movement, in any direction can be absorbed by the unit and not transmitted to the catheter. The best arrangement would depend on the materials employed and the exact configuration. The most likely configuration would involve the accordion or accordion thread configuration as the outside tube since it would yield the best stability with the greatest flexibility. It should be noted that a coiled tube within the container could provide this type of flexibility, but would be more difficult to control with a spring in an adjustable manner.

There is also the possible advantage that an accordion shaped compensatory section would help in the retardation of bacterial film growth within the tubing because of intermittent flow and the resulting flush action. Compare this to a smooth inner wall and a small continuous flow and the possible increased rate of bacterial film growth when given a continuous path.

Another embodiment is described in PPA 61/478,566 filed Apr. 25, 2011

There are many situations where a continuous tubal path for a liquid or gas is required, such as urinary catheter drainage, IV catheter fluid insertion, etc. In many of these cases a method that would compensate for changes in the tube path length and/or some form of tensioning control would be a very desirable feature. In some medical applications it could be life saving. Ideally, the tube should be continuous with a smooth interior fluid path and provide a high degree of extension with a low tensile force. The overall profile should be low with a minimum of projections to reduce chance of entanglement as well as to ensure comfort for the patient. It must be robust enough so that fluid flaw will not stop if pressure exerted on outside of tube.

Embodiment with Thin Wall Stretchable Tube

The embodiments described in FIGS. 13 a to FIG. 15 describe a continuous stretchable tubal path that has a high degree of extension at very low tensile forces by means of utilizing the elasticity of a very thin wall, easily collapsible elastomer or rubber like tube as part of the tubal path. It is accomplished by providing means to do the following:

-   -   a. Protecting the thin wall section from outside pressures     -   b. Never allowing the elastomer tube to become shorter in length         than its natural length when under no tension     -   c. Never allowing the elastomer tube from stretching beyond its         breaking length     -   d. Never allowing the elastomer tube from twisting

An example of the practical use for such a device would be as a part of a urinary catheter security device such as the one described in PPA No. 61/359,912. One need only to add a means of securing such a device to the thigh and the fittings necessary to attach the tubing to the urinary catheter on the one end and the tube leading to the collection bag on the other in order to get the conditions necessary to stabilize a urinary catheter. This arrangement would have many advantages over the methods described in PPA No. 61/359,912.

A further application would be to incorporate such an arrangement as applied to an IV catheter between the catheter and the medical tube feeding the IV. In such a case, the IV catheter would be fastened down after insertion and the tubing fastened down at a point in line with the catheter, with or without a slight degree of tension on the IV site. The application of a tension factor would reduce the degree of skin movement resulting in less needle movement within the vein. The stretch component would reduce the strain on the IV catheter if the medical tube, or the secondary attachment point of the tube were disturbed. This action would isolate the tube movement from the catheter thereby reducing the chance of the catheter either being dislodged or causing damage to the vein or bladder or most any body part a catheter may be employed.

DETAILED DESCRIPTION OF POSSIBLE MEANS TO SATISFY THE ABOVE EMBODIMENT FIG. 13

The incoming tube 12 1312 is glued to elastic tube 14 1314 on one side. The other side of the elastic tube is glued to exiting tube 13 1313. The incoming tube 12 1312 is glued to hole 17 in slider 16 1316, and is free to slide thru exiting hole 24 1324. The incoming tube 12 1312 is free to slide thru outer shell incoming end 1319. hole 9. Slider 16 1316 slides freely within outer shell 10 1310. The “D” shape of slider 16 1316, within the D shape of outer shell 10 1310 will prevent any twisting of elastic tube 14 1314. Outer shell incoming end 19 1319 prevents slider 16 1416 from any further outward movement thereby protecting elastic tube 14 1314 from over stretching. Maximum slider stop 22 1322 prevents slider 16 1316 from moving any closer to outer shell exiting end 11 1311, thereby insuring the minimum length condition needed to maintain elastic tube 14 1314 shape.

This arrangement has the outer tube protecting the elastic tube from outside pressures as well providing an environment where the elastic tube cannot be collapsed by shortening to below its natural length, stretched to its breaking point or twisted out of shape. The result is an elastic tube that is always open to provide a clear path for any fluid to pass through.

FIGS. 14A,14B, and 14C

Shows an extension or telescoping tube variation. With this arrangement, the elastic tube 1414 could be longer if desired without increasing the size of the device. This longer elastic tube will give a greater extension with a softer pull. This, together with the telescoping action, will result in less stress on the bladder as well as on the elastic tube in a device that is shorter and easier to manage. The actual stretch could equal the length of the elastic tube, which is about equal to the outer tube 1410 length. Further features, such as using the safety pin 1450 through hole 1418 to keep slider 1416 from moving toward the incoming end. Removing pin 1450 and freeing slider 1416 to move to stop 1442, will remove the initial constant tension component. This allows for adjustment and/or safe removal of tension during actual use by the nursing staff or by the patient.

FIG. 14A Shows an exploded view of an advanced model that has provision for adjusting or removing the tension on elastic tube 1414 as well as a telescoping shell arrangement that allows for greater stretch in a shorter device.

Exiting tube 1413 is glued to slider 1416 and then to elastic tube 1414 Tube 1414 is glued to incoming tube 1412. Tube 1412 is glued to inner shell incoming hole 1444 in inner shell back plate 1442 Back plate 1442 is glued to the incoming end of inner shell 1440.

FIG. 14B Same exploded view as 14A, but from opposing view.

FIG. 14C

Shows a cross section of the advanced model fully assembled. Exiting Tube 1413 slides freely in exiting hole 1424. Initially slider 1416 is restrained from moving within outer shell 1410 by safety pin 1450. Pin 1450 is held in place by raised projections 1452. These projections on safety pin 1450 are not high enough to prevent the pin 1450 from being removed from the entry holes on both sides of outer shell 1410 with a little additional force. The removal of the pin would allow slider 1416 to move over to secondary position 1449, shown as a dotted outline in FIG. 14C, and is stopped from moving any further be slider stop 1432. This movement is enough to remove the minimum tension employed when the device is used to maintain a minimal tension as described in PPA No. 61/359,912. When used in this position, safety pin 1450 could be reinserted to prevent the slider from moving back toward the exiting end. To prevent the elastic tubing from stretching to its breaking point as well as to prevent the inner shell from exiting out of the outer shell, inner shell maximum movement stop 1446 acts against inner shell stop 1434. Inner shell back plate 1442 is fastened t the incoming end of inner shell 1440. The inner shell leading edge 1448 against slider 16 1416 acts as the limiting condition for maintaining a minimum length of elastic tube.

Shows an exploded view of an advanced model that has provision for adjusting or removing the tension on elastic tube 1414 as well as a telescoping shell arrangement that allows for greater stretch in a shorter device.

Exiting tube 13 1413 is glued to slider 16 1416 and then to elastic tube 14 1414. Tube 14 1414 is glued to incoming tube 12 1412. Tube 1412 is glued to inner shell incoming hole 1444 in inner shell back plate 1442 Back plate 1442 is glued to the incoming end of inner shell 1440

The elastic tube 1414 was dip molded out of a two part elastomer made by “Smooth-on” named Dragon Skin Q. In this case the tube was plain, but it would be possible to provide special benefits if lateral and/or longitudinal ribs were molded in at the same time. The tube can be made of any suitable rubber like product.

FIGS. 15A and 15B

In one special variation of the device, the benefits of the flexible, stretchable feature can be applied to an IV device, as shown in 15A and 15B. In this case, the inner shell 1554 is shaped as shown to allow for more lateral movement of the incoming tube and better isolation of any incoming tube disturbance from affecting the IV needle position within the vein. In this case, the elastic tube 1514 would benefit if it had some small ribs for the short distance at the bending end. Since the rest of the tube would be of the same cross section, near maximum stretch would still be possible. The tension aspect of the device could cause a contraction of the skin between the IV site and the secondary tube attachment site. This contraction causes a significant reduction in skin movement at the IV site, and therefore results in less needle movement within the vein. The secondary tube attachment site could be a device such as the “Site-saver,” or any other method of securing the incoming tube at a point before it reaches the IV site. The secondary site is often used to reduce the strain resulting from outside tubal movement from affecting the IV needle site. As an added benefit, the flat underside of the IV Outer Shell 1552 enables the needle to be in a more parallel position relative to the skin, and therefore less likely to pierce the vein if disturbed. The larger area of the flat surface also lends itself to a more secure attachment zone, especially if a Velcro solution were to be employed.

FIG. 15A Shows an exploded view of an IV model that is yet another application of the same concept. In this case inner shell 1554 is shaped to allow much greater lateral movement. Outer shell 1552 fastened to IV needle/catheter 1556 and Iv needle/catheter 1556 is attached to elastic tube 1514. The other end of elastic tube 1514 is attached to incoming tube 1512 as well as inner shell 1554. Inner shell flare 1558 is designed to spread contact points of inner shell 1554 against elastic tube 1514 when in extreme lateral positions of the in coming tube.

FIG. 15B Shows a cross section of IV model.

Those of skill in the art will recognize certain modifications, permutations, additions and sub-combinations thereof of parts noted herein. While a device or an accompanying method have been described for what are presently considered the exemplary embodiments, the invention is not so limited. To the contrary, the invention is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims. The scope of the following claims is to be accorded the broadest interpretation so as to encompass all such modifications and equivalent structures and functions.

This arrangement has the outer tube protecting the elastic tube from outside pressures as well providing an environment where the elastic tube cannot be collapsed by shortening to below its natural 

1. A method for draining a bladder, comprising the steps of: a. Inserting a foley type catheter into the bladder b. Inflating the balloon section c. attaching a drainage tube to the catheter d. providing a controllable elasticized means for the drainage tube to expand or contract along the segment of tubing between the catheter and the point of securement on the thigh in order to compensate for changes in length between the catheter and the point of securement as a result of leg movement. e. Securing one end of the drainage tube on the thigh at a point in line with the catheter where the expandable means is partially engaged, thereby causing the minimal force needed to keep the catheter balloon resting on the bottom of the bladder when the legs are in a position that provides the shortest distance from the attachment point to the catheter. whereby the balloon on the catheter is now kept in contact with the base of the bladder with enough force to prevent pistoning of the catheter but not enough force to cause harm to the bladder by restricting blood flow in the area of balloon contact. The securement point also prevents all tube movements beyond the securement point from affecting the catheter.
 2. The method of claim 1 whereby the controlling means is adjustable thereby providing a mean for relieving the pressure of the balloon on the bladder bottom when it is so desired.
 3. The method of claim 2 wherein the controlling means is a spring or elastic element in combination with a bellows type or collapsible tube section rather than the looped drainage tube as shown in FIG. 12
 4. The method of claim 3 wherein the controlling means is a spring or elastic element in combination with a sliding a rigid tube within a tube to provide the compensation needed in drainage tube length.
 5. The method of claim 2 wherein the controlling means includes a means for finely adjusting the spring or the elastic component that acts on the bellows or the sliding tube.
 6. The method of claim 1 wherein the tube controlling means comprises a loop in a flexible tube secured with an elastic or spring across the base of the loop such that the loop can open as the distance from the point of attachment to the catheter changes as a result of leg movement. Fastening one end of the elastic band (with the tube attached) to a point on the thigh such that the band as well as the tube that is attached to the catheter is in essentially a straight line with the extruding end of the catheter and the leg is at the position where that distance is at a minimum. Attaching one end of the tube to the catheter and the other end to the collection bag Providing a cover sheet over the tubing to keep the tubing and the loop parallel to the thigh Whereby the drainage tube is least likely to become entangled, the tube is kept from swinging from one side to the other, and the low profile provides an ideal arrangement when worn under clothes.
 7. The method of claim 5, wherein the device is placed at a point that provides a minimum pre-set safe tension on the catheter when the balloon on the catheter is at the base of the bladder. Providing a cover sheet over the tubing to keep the tubing and the loop parallel to the thigh Whereby the cover sheet provides a low profile arrangement and also prevents the loop from being snagged or impeded and in so doing destroy the controlled tension on the catheter as well as helping to guide the loop back into position when the tube contracts.
 8. The method of claim 5 whereby the drainage tube is heat set to maintain the curvature needed to match the curvature of the device, which matches the curvature of the thigh, thereby further facilitating the re-entry of the tube into the device when the tube path contracts.
 9. A method to enable the use of a highly elastic, easily collapsible thin wall elastomer type tube as a segment of a continuous tubal path by: a. Providing a means that will not allow the elastic tube to become shorter than its natural (un-stretched) length b. Providing a means that will not allow the elastic tube to twist c. Priding a means that will limit total stretch to below the breaking point of the elastic tube d. Providing a means to protect the elastic tubing whether stretched or un-stretched from outside pressures that may cause the tube to collapse or otherwise interfere with the flow of material thru the tube path.
 10. A method as described in 9, that would allow the tubal path to stretch and retract using the elasticity of the elastic tube as the source of tension
 11. A method as described in 9, that would further provide a means to adjust the tension produced by the elastic means before and/or during use
 12. A method as described in 9, that would further provide a telescoping protective tube arrangement thereby enabling a greater degree of stretch as well as the use of a longer elastic tube in a shorter unit. 